Functional Recovery After Acute Myocardial InfarctionComparison Between Angiography, Electrocardiography, and Cardiovascular Magnetic Resonance Measures of Microvascular Injury
Robin Nijveldt, MD*, ,*,
Aernout M. Beek, MD*,
Alexander Hirsch, MD,||,
Martin G. Stoel, MD¶,
Mark B.M. Hofman, PhD ,
Victor A.W.M. Umans, MD, PhD#,
Paul R. Algra, MD, PhD**,
Jos W.R. Twisk, PhD and
Albert C. van Rossum, MD, PhD*,
* Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, the Netherlands
Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands
|| Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands
¶ Department of Cardiology, Medisch Spectrum Twente, Enschede, the Netherlands
# Department of Cardiology, Medical Center Alkmaar, Alkmaar, the Netherlands
** Department of Radiology, Medical Center Alkmaar, Alkmaar, the Netherlands.
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Figure 1 Changes in Global Left Ventricular Volumes and Function According to Late MVO Status
Changes in global left ventricular volumes and function from baseline to follow-up in patients without microvascular obstruction (MVO) (open squares) and with MVO (solid squares). Base = baseline; FU = follow-up.
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Figure 2 Changes in Regional Wall Thickness and Function in Dysfunctional Segments According to Infarct Transmurality and Presence of Late MVO
Change of end-diastolic and end-systolic regional wall thickness (A and B) and of wall thickening (C) in dysfunctional segments between baseline and follow-up according to transmural extent of infarction. (D) Complete recovery at follow-up of dysfunctional segments according to baseline transmural extent of infarction in patients without microvascular obstruction (MVO) (open squares) and with MVO (solid squares).
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Figure 3 Example of Gadolinium-Enhanced Images of the Same Patient With MVO at Different Time Points After Contrast Administration, Showing the Decline of the MVO Region
(A) Short-axis first-pass perfusion image 1.5 min after contrast bolus injection, with transmural hypoenhancement in the inferolateral region (arrows). (B to F) Corresponding 3-chamber LGE images which transect A at the dotted line, acquired 10 min (B), 15 min (C), 20 min (D), 30 min (E), and 40 min (F) after contrast administration.
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